IQ and the association with myopia in children

PURPOSE: To evaluate the association between intelligence and myopia in children. METHODS: Cycloplegic refraction and ocular biometry parameters, including axial length, vitreous chamber depth, lens thickness, anterior chamber depth, and corneal curvature were obtained in 1204 Chinese school children aged 10 to 12 years from three schools who were participants in the Singapore Cohort Study Of the Risk Factors for Myopia (SCORM). Intelligence quotient (IQ) was assessed using the nonverbal Raven Standard Progressive Matrix test. RESULTS: After controlling for age, gender, school, parental myopia, father's education, and books read per week, myopia (spherical equivalent [SE]) of at least -0.5 D was associated with high nonverbal IQ (highest quartile) versus low IQ (lowest quartile) (odds ratio = 2.4; 95% confidence interval, 1.7-3.4). Controlling for the same factors, children with higher nonverbal IQ scores had significantly more myopic refractions (-1.86 D for children with nonverbal IQ in the highest quartile compared with -1.24 D for children with nonverbal IQ in the lowest quartile; P = 0.002) and longer axial lengths (24.06 mm versus 23.80 mm; P = 0.022). Nonverbal IQ accounted for a greater proportion of the variance in refraction compared with books read per week. CONCLUSIONS: Nonverbal IQ may be an independent risk factor of myopia, and this relationship may not be explained merely by increased reading (books per week) among myopes. An interesting observation is that nonverbal IQ may be a stronger risk factor for myopia compared with books read per week. The complexity of the relationships between nonverbal IQ, reading, and myopia warrant additional studies to clarify any cause-effect relationship.     

Nearwork in early-onset myopia

PURPOSE: To determine the relationship of nearwork and myopia in young elementary school-age children in Singapore. METHODS: A cross-sectional study of 1005 school children aged 7 to 9 years was conducted in two schools in Singapore. Cycloplegic autorefraction, keratometry, and biometry measurements were performed. In addition, the parents completed a detailed questionnaire on nearwork activity (books read per week, reading in hours per day and diopter hours [addition of three times reading, two times computer use, and two times video games use in hours per day]). Other risk factors, such as parental myopia, socioeconomic status, and light exposure history, were assessed. RESULTS: In addition to socioeconomic factors, several nearwork indices were associated with myopia in these young children. The multivariate adjusted odds ratio of higher myopia (at least -3.0 D) for children who read more than two books per week was 3.05 (95% confidence interval [CI], 1.80-5.18). However, the odds ratios of higher myopia for children who read more than 2 hours per day or with more than 8 diopter hours (1.50; 95% CI, 0.87-2.55 and 1.04; 95% CI, 0.61-1.78, respectively) were not significant, after controlling for several factors. CONCLUSIONS: Children aged 7 to 9 years with a greater current reading exposure were more likely to be myopic. This association of reading and myopia in a young age cohort was greater than the strength of the reading association generally found in older myopic subjects. Whether these results identify an association of early-onset myopia with nearwork activity or other potentially confounding factors is discussed.     

Incidence and progression of myopia in Singaporean school children

PURPOSE: To determine the incidence and progression rates of myopia in young Singaporean children. METHODS: A prospective cohort study, the Singapore Cohort Study of the Risk Factors for Myopia (SCORM), was conducted in two schools in Singapore (1999-2002). Children aged 7 to 9 years (n=981) were followed up over a 3-year period. Cycloplegic autorefraction and biometry parameter measures were performed annually, according to the same protocol. RESULTS: The 3-year cumulative incidence rates were 47.7% (95% confidence interval [CI]: 42.2-53.3), 38.4% (95% CI: 31.4-45.4), and 32.4% (95% CI: 21.8-43.1) for 7-, 8-, and 9-year-old children, respectively. The 3-year cumulative incidence rates were higher in Chinese (49.5% vs. 27.2%) and in 7-year-old compared with 9-year-old children at baseline (47.7% vs. 32.4%), though the latter relationship was of borderline significance after adjustment for race, gender, amount of reading (books/week), and parental myopia (P=0.057). Premyopic children with greater axial lengths, vitreous chamber depths, and thinner lenses were more prone to the development of myopia, after controlling for age, gender, race, reading, and parental myopia. The 3-year mean cumulative myopia progression rates were -2.40 D (95% CI: -2.57 to -2.22) in 7-year-old myopic children, -1.97 (95% CI: -2.16 to -1.78) in 8-year-olds, and -1.71 (95% CI: -1.98 to -1.44) in 9-year-olds. CONCLUSIONS: Both the incidence and progression rates of myopia are high in Singaporean children.     

School grades and myopia

AIM: To evaluate the association between school performance and myopia in Singapore children. METHODS: Children aged 10-12 years from two schools in the Singapore Cohort study Of the Risk factors for Myopia (SCORM) were included. Results of a Year 4 standard nation-wide examination were obtained. Cycloplegic autorefraction and A-scan ultrasound biometry measurements were performed in the schools. RESULTS: The odds ratio for myopia (defined as right eye spherical equivalent at least -0.5 D) was 2.5 (95% confidence interval 1.4-4.5) for children with average school examination scores in the fourth quartile compared with the first, after adjusting for confounders including reading in books per week and IQ test scores. Similar significant associations were found for English language (p = 0.001) and native language school examination scores (p < 0.001), while the associations with mathematics school examination scores were of borderline significance (p = 0.055). CONCLUSION: School grades, a possible indicator of either cumulative engagement in near work activity or intelligence, were positively associated with myopia in Singapore children.     

Refractive errors and 10-year incidence of age-related maculopathy

PURPOSE: To describe the relationship of refractive errors to the 10-year incidence of age-related maculopathy (ARM) in a defined white population. METHODS: Persons aged 43 to 86 years of age in Beaver Dam, Wisconsin, were invited for a baseline examination from 1988 through 1990, and follow-up examinations 5 and 10 years later (n = 3684). Refraction was measured at baseline, with myopia defined as a spherical equivalent of -1.00 D or less, emmetropia as -0.75 to +0.75 D and hyperopia as +1.00 D or more. At each examination, signs of ARM were ascertained from grading stereoscopic color fundus photographs based on a standard protocol. The association between baseline refractive status and the 10-year incidence and progression of ARM was analyzed. RESULTS: The 10-year cumulative incidence for early ARM was 7.1%, 7.7%, and 11.7%, in eyes with myopia, emmetropia, and hyperopia, respectively. The corresponding 10-year cumulative incidence for late ARM was 0.3%, 0.8%, and 2.2%. When age was controlled for, there was no association between myopia and incident early (relative risk [RR] 1.0, 95% confidence interval [CI], 0.7-1.3) and late (RR 0.5, 95% CI, 0.2-1.5) ARM. Similarly, after controlling for age, hyperopia was not associated with incident early (RR 0.9, 95% CI, 0.7-1.1) or late (RR 1.2, 95% CI, 0.6-2.3) ARM. CONCLUSIONS: These prospective population-based data provide no evidence of an association between refractive errors and risk of ARM.     

Longitudinal study of anisometropia in Singaporean school children

PURPOSE: The purpose of this study was to document the incidence rates of anisometropia, year-by-year prevalences, changes in the intereye difference in spherical equivalent (SE), and its association with myopia progression and axial length changes in a cohort of Singaporean school children. METHODS: This is a prospective cohort study of Singaporean school children (n = 1979) aged 7 to 9 years who were examined annually with cycloplegic refraction and ultrasonography over a 3-year period. RESULTS: In the 1908 children without anisometropia at commencement, the 3-year cumulative incidence rate of anisometropia (difference in SE at least 1.0 D) was 144 (7.55%; 95% CI: 6.42-8.85). The mean intereye difference in SE in all children at baseline was 0.29 +/- 0.46 D (SD: 0.46) and increased to 0.44 D (0.59) on the last examination. On the initial examination, 3.6% (95% CI: 2.8-4.4) or 71 children had anisometropia. Of the 59 of 71 children who completed all examinations, only 3 (5.1%) had an increase in the intereye difference in SE by at least 0.5 D, whereas 2 (3.4%) had a decrease of at least 0.5D. The mean intereye difference in SE was stable between visits. The change in intereye difference in SE correlated with the change in intereye axial length (r = 0.43). Compared with the isometropic children, each eye of the anisometropic children had a higher rate of progression of myopia. CONCLUSIONS: The 3-year incidence of anisometropia was 7.55% in these young Singaporean children. Although the frequency of anisometropia increased with time, the difference in SE between eyes tended to remain stable.     

Component dependent risk factors for ocular parameters in Singapore Chinese children

OBJECTIVE: To examine the risk factors for variations in ocular biometry parameters in Singapore Chinese children, a population with a known high prevalence rate of myopia at an early age. DESIGN: Cross-sectional study. PARTICIPANTS: Children aged 7 to 9 years (n = 1453) from three schools in Singapore. METHODS: The children underwent A scan biometry and cycloplegic autorefraction measurements. Questions were asked regarding number of books read per week, night lighting, and parental myopia. MAIN OUTCOME MEASURES: Axial length, vitreous chamber depth, lens thickness, anterior chamber depth, refraction, and corneal curvature radius measurements were made. RESULTS: After controlling for several factors, the axial lengths were found to be longer and vitreous chambers deeper in children who were older, male, read more than two books per week, or taller, and those who had at least one parent who was myopic. In these models, children who read more than two books per week had axial lengths that were 0.17 mm longer and vitreous chambers that were 0.15 mm deeper compared with children who read two or fewer books per week. Anterior chambers were deeper in males and taller children, whereas corneal curvature was steeper in female, older, and shorter children. CONCLUSIONS: Increases of axial length and vitreous cavity depth were associated with older age, being male, reading more than two books per week, increased height, and parental history of myopia. Of these risk factors, however, neither reading nor parental myopia history were associated with values for anterior chamber depth, corneal curvature, or lens thickness. These findings confirm that conventional risk factors for myopia associated with the vitreous cavity, but suggest that anterior segment parameters such as corneal curvature and lens thickness may be subject to unrelated postnatal growth control mechanisms.     

Nine-year refractive changes in the Barbados Eye Studies

PURPOSE: To describe 9-year changes in refractive errors and estimate incidence of myopia and hyperopia in adults of African-descent, along with associated risk factors. METHODS: The 9-year follow-up of the Barbados Eye Studies (1997-2003) reexamined 2793 surviving cohort members (81% participation). Refractive errors were determined by automated refraction. Myopia/hyperopia were defined as spherical equivalent < -0.5 diopters (D)/> +0.5 D, and the cutoff for moderate-high myopia/hyperopia was 3.0 D. Incidence rates of myopia/hyperopia were estimated by the product-limit approach, based on eyes without such conditions at baseline. Risk factors were evaluated by logistic regression in discrete time hazard models. RESULTS: Nine-year refraction changes varied by age. Persons aged 40 to 49 years experienced hyperopic shifts (median, +0.38 D), whereas persons > or =60 years had myopic shifts (median, -0.75D). Overall 9-year incidence was 12.0% for myopia and 29.5% for hyperopia; rates were 3.6% and 2.0% for moderate-high myopia and hyperopia, respectively. Myopia risk increased with age, baseline nuclear lens opacities (risk ratio [RR] = 1.7; 95% confidence interval [CI]: 1.01-2.9), glaucoma (RR = 6.0, 95% CI: 3.9-9.3), and ocular hypertension (RR = 2.0, 95% CI: 1.3-3.0), while cortical lens opacities decreased risk (RR = 0.6, 95% CI: 0.4-0.9). Incidence of moderate-high myopia was also related to baseline age, nuclear opacities, glaucoma, male gender (RR = 1.7, 95% CI: 1.0-2.8), and diabetes history (RR = 1.9, 95% CI: 1.01-3.5). Hyperopia risk decreased with older age, male gender, and glaucoma diagnosis. CONCLUSIONS: Refractive errors continue to develop frequently in older adults. Nuclear lens opacities, glaucoma, and diabetes increase the risk of older-onset myopia, a result of public health relevance to this and similar African-origin populations.     

Prevalence of refractive errors in teenage high school students in Singapore

We aimed to study the prevalence of refractive conditions in Singapore teenagers. Grade 9 and 10 students (n = 946) aged 15-19 years from two secondary schools in Singapore were recruited. The refractive errors of the students' eyes were measured using non-cycloplegic autorefraction. Sociodemographic data and information on risk factors for myopia (such as reading and writing) were also obtained using an interviewer-administered questionnaire. The prevalence of refractive conditions was found to be: myopia [spherical equivalent (SE) at least -0.50 D] - 73.9%, hyperopia (SE at least +0.50 D) - 1.5%, astigmatism (cylinder at least -0.50 D) - 58.7% and anisometropia (SE difference at least 1.00 D) - 11.2%. After adjusting for age and gender, currently doing more than 20.5 h of reading and writing a week was found to be positively associated with myopia [odds ratio 1.12 (95% CI 1.04-1.20, p = 0.003)], as was reading and writing at a close distance and a better educational stream. The prevalence of myopia (73.9%) in Singapore teenagers is high. Current reading and writing habits, reading at close distances and a better educational stream are possible risk factors for myopia.     

厦门地区城市与农村儿童近距离用眼与近视的关系

目的 :调查中国厦门城市与农村 8～ 9岁儿童近视的患病情况 ,并以此评估环境因素对近视患病率的影响。方法 :对中国厦门城市 (n =119)和农村 (n =91)的小学二年级学生进行散瞳电脑验光和眼生物参数测量 ,并采用同一标准的调查表进行面对面地问卷调查 ,内容包括社会经济地位、近距离用眼活动情况、读写习惯、近视眼家族史等。结果 :近视的发病率在城市为 19.3% [95 %可信区间confidenceinterval(CI) :12 .3,2 9],在农村是 6 .6 % (95 %CI:2 .4 ,14 .3)。城市在校学生每天课外读写平均时间是 2 .2h ,农村学生的收稿日期 :2 0 0 2 -0 3 -14 ;修回日期 :2 0 0 2 -0 5 -0 8基金项目 :新加坡政府及厦门开元区科委资助项目。作者简介 :张铭志 (195 7-) ,女 ,山东费县人 ,医学硕士 ,副主任医师。研究方向 :白内障、青光眼、近视。通信作者 :张铭志 (E -mail:fu- zhifu @hotmail.com)。时间是 1.6h(P <0 .0 0 1) ,所得结果经近视眼家族史因素校正后 ,总体读写时间比值比为 2 .2 (95 %CL :1.1,4 )。结论 :近视眼发病率 ,城市高于农村。城市儿童的课外读书时间比农村儿童长 ,城市和农村的近视儿童在读书上花费的时间明显高于非近视儿童。近距离用眼的增多可能导致了近视眼的发生 ,这为近距离用眼学说提供了更多依据     

Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore

AIM: To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore. METHODS: Children aged 7-9 years from three schools in the Singapore Cohort study of the Risk factors for Myopia (n = 1962) and similarly aged children from a random cluster sample in the metropolitan Kuala Lumpur area in the Malaysia Refractive Error Study in Children (n = 1752) were compared. Cycloplegic autorefraction was conducted in both countries. RESULTS: The prevalence of myopia (spherical equivalent of at least -0.5 diopters (D) in either eye) was higher in Singapore Malays (22.1%) than in Malays in Malaysia (9.2%; 95% confidence interval (CI) 11.2 to 14.7; p<0.001). Similarly, Singapore Chinese (40.1%) had higher prevalences than Malaysian Chinese (30.9%; 95% CI 1.5 to 16.9). Singapore Indians had a higher prevalence (34.1%) than Malaysian Indians (12.5%; 95% CI 17.4 to 25.9). The multivariate odds ratio of astigmatism (cylinder at least 0.75 D in either eye) in Singapore Malays compared with Malaysian Malays was 3.47 (95% CI 2.79 to 4.32). Ethnicity-specific hyperopia rates did not differ in Singapore and Malaysia. CONCLUSION: The ethnicity-specific prevalences of myopia in Singapore Malays, Chinese and Indians are higher than those in Malaysian Malays, Chinese and Indians. As Malays, Chinese and Indians in Malaysia have genetic make-up similar to that of Malays, Chinese and Indians in Singapore, environmental factors may contribute to the higher myopia rates.     

Prevalence, incidence, and progression of myopia of school children in Hong Kong

PURPOSE: To determine the prevalence, incidence, and progression of myopia of Chinese children in Hong Kong. METHODS: A cross-sectional survey was initially conducted. A longitudinal follow-up study was then conducted 12 months later. RESULTS: A total of 7560 children of mean age 9.33 (95% confidence interval [CI] = 9.11-9.45; range, 5-16) participated in the study. Mean spherical equivalent refraction (SER) was -0.33 D (SD = 11.56; range, -13.13 to +14.25 D). Myopia (SER 相似文献   

Refractive errors,intraocular pressure,and glaucoma in a white population

OBJECTIVE: To examine the relation of refractive errors to glaucoma and intraocular pressure (IOP) in a defined white population. DESIGN: Population-based cross-sectional and follow-up study. PARTICIPANTS: Persons aged 43 to 86 years living in Beaver Dam, Wisconsin (n = 4926). METHODS: All participants received a standardized assessment of refraction, IOP, and glaucoma at baseline (1988-1990), with IOP remeasured 5 years later (1993-1995). Refraction was defined at baseline as follows: myopia as spherical equivalent of -1.00 diopters (D) or less, emmetropia as -0.75 to +0.75 D, and hyperopia as +1.00 D or more. MAIN OUTCOME MEASURES: Relation of baseline refraction to prevalent glaucoma (defined from IOP, optic disc, and visual field criteria) and incident ocular hypertension (defined as IOP more than 21 mmHg at the 5-year examination in eyes with IOP of 21 mmHg or less at baseline). RESULTS: A myopic refraction was correlated with increasing IOP at baseline (P < 0.001). After controlling for age and gender, persons with myopia were 60% more likely to have prevalent glaucoma than those with emmetropia (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1, 2.3). In contrast, controlling for age, gender, and baseline IOP, persons with hyperopia were 40% more likely to have incident ocular hypertension than those who were emmetropic at baseline (OR, 1.4; 95% CI, 1.0, 2.0). Myopia was not related to incident ocular hypertension. CONCLUSIONS: In these population-based data, there was a cross-sectional association of myopia with higher IOP and prevalent glaucoma. Similar associations have been found in previous studies. Hyperopia may be associated with 5-year risk of ocular hypertension, a finding that needs further investigation.     

A randomized trial of rigid gas permeable contact lenses to reduce progression of children's myopia

PURPOSE: To test whether rigid gas permeable (RGP) contact lens wear can reduced the rate of myopia progression in school age children. DESIGN: Randomized clinical trial. METHODS: SETTING: Single clinical center. STUDY POPULATION: Both eyes of 428 Singaporean children. INCLUSION CRITERIA: 6 through 12 years of age with myopia between -1 and -4 diopters, astigmatism 相似文献   

Eye growth changes in myopic children in Singapore

AIMS: To assess the longitudinal changes in biometric parameters and associated factors in young myopic children aged 7--9 years followed prospectively in Singapore. METHODS: Children aged 7--9 years from three Singapore schools were invited to participate in the SCORM (Singapore Cohort study Of the Risk factors for Myopia) study. Yearly eye examinations involving biometry measures were performed in the schools. Only myopic children (n=543) with 3 year follow up data were included in this analysis. RESULTS: The 3 year increases in axial length, anterior chamber depth, lens thickness, vitreous chamber depth, and corneal curvature were 0.89 mm, -0.02 mm, -0.01 mm, 0.92 mm, and 0.01 mm, respectively. Children who were younger, female, and who had a parental history of myopia were more likely to have greater increases in axial length. After adjustment for school, age, sex, race, parental myopia and reading in books per week, the age (p<0.001), sex (p=0.012), and parental myopia (p=0.027) remained significantly associated with the 3 year change in axial length. Reading in books per week, however, was not associated with axial length change. Children with faster rates of progression of myopia had greater increases in axial length (Pearson correlation coefficient (r)=-0.69) and vitreous chamber depth (r=-0.83). CONCLUSIONS: The 3 year change in axial length of Singapore children aged 7--9 years at baseline was high and greater in younger children, females, and children with a parental history of myopia. Myopia progression was driven largely by vitreous chamber depth increase.     

Prevalence rates of refractive errors in Sumatra,Indonesia

PURPOSE: To determine the prevalence rates of myopia, hyperopia, astigmatism, and anisometropia in a prevalence survey of adults in Sumatra, Indonesia. METHODS: A population-based prevalence survey of 1043 adults 21 or more years of age was conducted in five rural villages and one provincial town of the Riau Province, Sumatra, Indonesia. A one-stage household cluster sampling procedure was used wherein 100 households were selected from each village or town. Refractive error measurements were obtained with one of two handheld autorefractors. Household interviews were conducted to obtain information on relevant lifestyle risk factors. RESULTS: The age-adjusted overall prevalence rates of myopia (SE [spherical equivalent] at least -1.0 D), hyperopia (SE of at least +1.0 D), astigmatism (cylinder of at least -1.0 D), and anisometropia (SE difference of +1.0 D) were 26.1% (95% confidence interval [CI]: 23.4-28.8), 9.2% (95% CI: 7.4-11.0), 18.5% (95% CI: 16.2-20.8), and 15.1% (95% CI: 12.9-17.4), respectively. The age-adjusted overall prevalence rate of high myopia (SE at least -6.0 D) was 0.8% (95% CI: 0.2-1.5). In a multiple logistic regression model, myopia rates varied with age and increased with income. Hyperopia, astigmatism, and anisometropia rates were independently higher in older adults. CONCLUSIONS: The prevalence rates of myopia in provincial Sumatra are higher than the rates in white populations, but lower than the rates in other urbanized Asian countries such as Singapore. The prevalence rate of high myopia is lower than in most other populations, and other refractive errors are common.     

Myopia and incident cataract and cataract surgery: the blue mountains eye study

PURPOSE: To assess whether an association exists between myopia and incident cataract and cataract surgery in an older population-based cohort study. METHODS: The Blue Mountains Eye Study examined 3654 participants aged 49 years or more during 1992 to 1994 and then 2334 (75.1%) of the survivors after 5 years. A history of using eyeglasses for clear distance vision was obtained. Objective refraction was performed with an autorefractor, followed by subjective refraction with a logarithm of minimum angle of resolution (logMAR) chart. Emmetropia was defined as a spherical equivalent refraction between +1 D and -1 D, hyperopia as more than +1 D, and myopia as less than -1 D. Slit lamp and retroillumination lens photographs were graded for presence of cortical, nuclear, or posterior subcapsular cataract, according to the Wisconsin Cataract Grading System. Generalized estimating equation models analyzed data by eye. RESULTS: There was a statistically significant association between high myopia (-6 D or less) and incident nuclear cataract (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.5-7.4). Incident posterior subcapsular cataract was associated with any myopia (OR 2.1, 95% CI 1.0-4.8), moderate to high myopia (-3.5 D or less, OR 4.4, 95% CI 1.7-11.5), and use of distance glasses before age 20 (OR 3.0, 95% CI 1.0-9.3), after adjustment for multiple potential confounders, including severity of nuclear opacity. Incident cataract surgery was significantly associated with any myopia (OR 2.1, 95% CI 1.1-4.2) as well as moderate (-3.5 to more than -6D; OR 2.9, 1.2-7.3) and high myopia (OR 3.4, 95% CI 1.0-11.3). CONCLUSIONS: These epidemiologic data provide some evidence of an association between myopia and incident cataract and cataract surgery, after adjustment for multiple confounders and severity of nuclear opacity. These data support other cross-sectional and longitudinal population-based findings.     

Myopia, axial length, and OCT characteristics of the macula in Singaporean children

PURPOSE: The purpose of this study was to evaluate the associations between macular volume and thickness, as assessed by optic coherence tomography (OCT), with refraction and axial length (AL) in children. METHODS: A total of 104 Chinese school children (51 girls and 53 boys) 11 to 12 years of age were randomly selected from one school during the 2005 examination in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Cycloplegic autorefraction was performed to obtain refraction (defined as spherical equivalent [SE]) and ultrasound biometry performed to obtain the AL. Macular volume and thickness were then measured (StratusOCT3; Carl Zeiss Meditec, Dublin, CA). RESULTS: Children with moderate myopia (SE at least -3.0 D) tended to have smaller total macular volume and thinner quadrant-specific macular thickness (except in the inferior and superior inner quadrants), followed by children with low myopia (-0.5-0.5 D). Total macular volume was positively associated with SE (beta=1.58, 95% CI, 0.84 to 2.32, standardized beta=0.14, P<0.001) and negatively associated with AL (beta=-1.20, 95% CI, -1.62 to -0.79, standardized beta=0.45, P<0.001) in multiple linear regression models controlling for age and gender. CONCLUSIONS: In children, increasing axial myopia was associated with reduced macular volume and thickness. These findings suggest that early anatomic changes may be present in the retinas of children with axial myopia.     

Risk factors of ophthalmic disorders in children with developmental delay

Purpose: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. Methods: A cross‐sectional study of 1126 Danish children with developmental delay (IQ ≤ 80), aged 4–15 years [mean age 10 years 1 month; standard deviation (SD) 3 years 2 months; 702 boys, 424 girls]. Ophthalmological and paediatric data were obtained from 719 children. The relative risks (RRs) of ophthalmic disorders were calculated for low IQ, low birth weight, low gestational age, asphyxia, cerebral palsy (CP), epilepsy, neuroradiologically verified cerebral abnormalities, Down’s syndrome and other genetic syndromes. Results: Adjusted RR showed that visual impairment was correlated to CP [RR 2.3, 95% confidence interval (CI) 1.3–4.2], epilepsy (RR 2.5, 95% CI 1.5–4.2), verified cerebral changes (RR 1.9, 95% CI 1.1–3.3) and Down’s syndrome (RR 2.7, 95% CI 1.2–6.3). Adjusted RR showed that refractive errors were correlated to CP (RR 1.5, 95% CI 1.1–2.1) and Down’s syndrome (RR 2.2, 95% CI 1.5–3.2). Adjusted RR showed that strabismus was correlated to cerebral changes (RR 1.8, 95% CI 1.2–2.5). Conclusion: The RR of ophthalmic disorders in developmentally delayed children is increased if the child has CP, epilepsy, verified cerebral abnormalities or a genetic syndrome; referral for ophthalmological evaluation should be performed on suspicion of these conditions.